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General NPI Number Information
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NPI Number | 1558528851
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Entity Type | Organization
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Legal Business Name | THE SIMIAN DIAGNOSTIC LABORATORY, LTD
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 7540 LOUIS PASTEUR STE 250
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4018
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Country | US
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Telephone | 210-615-7275
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 40100
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City | SAN ANTONIO
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State | TX
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Zip | 78229-1100
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Country | US
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Telephone | 210-615-7275
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RON A BERGER
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Credential |
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Telephone | 210-615-7275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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